Older adults with HIV: An overlooked population?

WASHINGTON -- When it comes to HIV prevention and treatment, there is a growing population that is being overlooked -- older adults -- and implicit ageism is partially responsible for this neglect, according to a presentation at the 125th Annual Convention of the American Psychological Association.

"The lack of perceived HIV risk in late adulthood among older people themselves, as well as providers and society in general, inhibits investment in education, testing and programmatic responses to address HIV in an aging population," said presenter Mark Brennan-Ing, PhD, director for research and evaluation at ACRIA, a non-profit HIV/AIDS research organization in New York City. "Ageism perpetuates the invisibility of older adults, which renders current medical and social service systems unprepared to respond to the needs of people aging with HIV infection."

There is an enduring misconception that HIV is a disease of the young, and in particular young gay and bisexual men, according to Brennan-Ing, but it is estimated that in developed countries with well-developed health care systems, almost half of all people living with HIV are 50 or older. In some countries, that number is expected to increase to 70 percent by 2020. People 50 and older account for 17 percent of new HIV infections, and are more likely than younger adults to be diagnosed with AIDS at the same time as they discover their HIV status.

Previous research has suggested as many as two-thirds of all older Americans with HIV have experienced stigma due not only to the disease, but to their age. This phenomenon may be even more pronounced among gay and bisexual men, because of an increased obsession with age and internalized ageism within the gay community.

Despite a median age of 58, older Americans with HIV are more likely to exhibit characteristics of people in their 60s, 70s or even 80s, said Brennan-Ing. The combination of stigma due to age, sexual orientation, race/ethnicity, gender identity and expression, and HIV can lead to a number of negative outcomes specific to this population.

"Stigma results in social isolation, either through rejection by social network members or self-protective withdrawal, leading to loneliness and, ultimately, depression," he said. "Stigma also makes people reluctant to disclose their HIV status, which could affect their health care treatment or prevent them taking precautions to reduce transmission."

Older individuals who believe in the negative stereotypes associated with aging can also have poor health outcomes. Negative expectations about aging have been associated with poor cognitive test performance in older individuals and can increase stress, resulting in physical health issues, such as heart disease. More important, if an individual believes that aging leads to inevitable health problems and decline, that person may stop engaging in healthy behaviors, creating a self-fulfilling prophecy.

"These mechanisms may be responsible for empirical findings that internalized ageism is related to both chronic disease and longevity," he said.

While it may not be possible to reduce ageism at the societal level, there are opportunities at the community level for providers of health and human services to buffer or reduce the impact of ageism for those who are infected or at risk for HIV, he said.

Specifically, Brennan-Ing recommended:

Training health providers in HIV screening, early diagnosis and initiation of antiretroviral therapy in older populations and integration of key services.

Prevention, education and outreach targeting older adults.

Treatment guidelines for older individuals with HIV.

Funding in line with the aging of the epidemic.

Engagement of communities, community-based organizations and social service providers in outreach, mental health and social support.

Addressing the needs of special populations.

"With the demographic shift toward older adults in the HIV population globally, and the elusiveness of a cure, addressing the care needs of this aging population are paramount," said Brennan-Ing. "The aging of the HIV epidemic will be very challenging, but provides the opportunity to mount a global response that will address the needs of this population across regions and settings."

The American Psychological Association, in Washington, D.C., is the largest scientific and professional organization representing psychology in the United States. APA's membership includes nearly 115,700 researchers, educators, clinicians, consultants and students. Through its divisions in 54 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance the creation, communication and application of psychological knowledge to benefit society and improve people's lives.

The Lancet HIV: New HIV infections stagnating at 2.5 million a year worldwideA major new analysis from the Global Burden of Disease 2015 study, published today in The Lancet HIV journal, reveals that although deaths from HIV/AIDS have been steadily declining from a peak in 2005, 2.5 million people worldwide became newly infected with HIV in 2015, a number that hasn't changed substantially in the past 10 years.

Study examines risk of HIV transmission from condomless sex with virologically suppressed HIV infectionAmong nearly 900 serodifferent (one partner is HIV-positive, one is HIV-negative) heterosexual and men who have sex with men couples in which the HIV-positive partner was using suppressive antiretroviral therapy and who reported condomless sex, during a median follow-up of 1.3 years per couple, there were no documented cases of within-couple HIV transmission, according to a study appearing in the July 12 issue of JAMA, an HIV/AIDS theme issue.

The world's leading experts provide all the 'essentials' needed to manage HIV patients in the office, on the ward, and in the ICU.

Completely revised and updated, HIV Essentials 2017 incorporates the latest clinical guidelines into a step-by-step guide to the diagnosis, evaluation, management, and prevention of HIV infection and its complications. Topics include: opportunistic infections and other HIV complications, treatment of HIV and pregnancy, antiretroviral drug summaries, post-exposure prophylaxis, as well as commercially available dosage forms for all ARVs. View Details

This HIV/AIDS summarizes National Clinical Guidelines with an attempt to achieve brevity, clarity and accuracy in guiding clinical decisions relevant to the management of adult patients with HIV/AIDS. This guide includes expanded drug-drug interactions tables, antiretroviral pictures tables, and summary of treatment guidelines.

Completely updated for 2017, Fundamentals of HIV Medicine is a comprehensive clinical care publication for the treatment of HIV/AIDS. Published by the American Academy of HIV Medicine, the book offers physicians, pharmacists, nurse practitioners, and other care providers the most up-to-date overview of the latest HIV treatments and guidelines plus online access to CME. The online access expires August 2018.

Completely updated to the current care guidelines from the Centers for Disease Control and elsewhere, this book addresses the current emphasis on managing medications for HIV treatment and many of the illnesses that commonly occur along with HIV. Combining the latest medical advice with the ideas of hundreds of people living with HIV, the book is helpful for adults living with HIV, and for friends, family members, and others who support anyone struggling with HIV. New additions to this edition include topics such as aging with HIV and coping with the emotions brought about by being a... View Details

Whether you're a newly diagnosed patient or a friend or relative of someone suffering from HIV or AIDS, this book can help. Offering both doctor and patient perspectives, 100 Questions & Answers About HIV and AIDS, Fourth Edition provides authoritative and practical answers to the most commonly asked questions by patients and their loved ones. What is the difference between HIV and AIDS? How can HIV infection be prevented? How do I find the right medical care?

Along with the answers to these and other questions, this book provides information on diagnosis, treatment, living with HIV... View Details

In this "frightening and fascinating masterpiece" (Walter Isaacson), David Quammen explores the true origins of HIV/AIDS.

The real story of AIDS―how it originated with a virus in a chimpanzee, jumped to one human, and then infected more than 60 million people―is very different from what most of us think we know. Recent research has revealed dark surprises and yielded a radically new scenario of how AIDS began and spread. Excerpted and adapted from the book Spillover, with a new introduction by the author, Quammen's hair-raising investigation tracks the... View Details

In 2008 it was believed that HIV/AIDS was without doubt the worst epidemic to hit humankind since the Black Death. The first case was identified in 1981; by 2004 it was estimated that about 40 million people were living with the disease, and about 20 million had died. Yet the outlook today is a little brighter. Although HIV/ AIDS continues to be a pressing public health issue the epidemic has stabilised globally, and it has become evident it is not, nor will it be, a global issue. The worst affected regions are southern and eastern Africa. Elsewhere, HIV is found in specific, usually,... View Details

In 1994, at the height of the AIDS epidemic in the United States, MK Czerwiec took her first nursing job, at Illinois Masonic Medical Center in Chicago, as part of the caregiving staff of HIV/AIDS Care Unit 371. Taking Turns pulls back the curtain on life in the ward.

A shining example of excellence in the treatment and care of patients, Unit 371 was a community for thousands of patients and families affected by HIV and AIDS and the people who cared for them. This graphic novel combines Czerwiec’s memories with the oral histories of patients, family members, and staff. It... View Details

HIV is a syndrome that causes the immune system of the human body to deteriorate, leaving it prone to develop chronic and often fatal diseases. This book on HIV infection discusses the clinical development of the disease as well as its various stages. Infection is followed by a period of latency and preliminary symptoms include fever, rashes, swollen lymph nodes and mononucleosis-like infections. This book is compiled in such a manner, that it will provide in-depth knowledge about the diagnosis and treatment of HIV. It will provide comprehensive knowledge to the readers. View Details

In its updated and expanded second edition, this helpful guide offers a wealth of information for people living with HIV and for people caring for HIV-positive loved ones. All aspects of HIV/AIDS are discussed, including opportunistic and associated infections, dental care, exercise and nutrition, substance use and abuse and emotional treatment. New information will help the newly diagnosed adjust to their illness and long-term survivors to improve their quality of life. Up-to-date discussion of the latest medications covers the growing practice of using HIV drugs as preventatives. Essential... View Details

Best Science Podcasts 2018

We have hand picked the best science podcasts for 2018. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.

Inspire To ActionWhat motivates us to take up a cause, follow a leader, or create change? This hour, TED speakers explore stories of inspirational leadership, and what makes some movements more successful than others. Guests include high school history teacher Diane Wolk-Rogers, writer and behavioral researcher Simon Sinek, 2016 Icelandic presidential candidate Halla TÃ³masdÃ³ttir, professor of leadership Jochen Menges, and writer and activist Naomi Klein.

#474 Appearance MattersThis week we talk about appearance, bodies, and body image. Why does what we look like affect our headspace so much? And how do we even begin to research a topic as personal and subjective as body image? To try and find out, we speak with some of the researchers at the Centre for Appearance Research (CAR) at the University of the West of England in Bristol. Psychology Professor Phillippa Diedrichs walks us through body image research, what we know so far, and how we know what we know. Professor of Appearance and Health Psychology Diana Harcourt talks about visible...